766B LAKELAND DR
JACKSON, MS 39216-4610 US PECOS Enrolled
Dominique Mechelle Jackson
Nurse Practitioner
- JACKSON, MS
- Phone: (601)-982-2916
- Last Updated 4/20/2021
Overview
Dominique Mechelle Jackson is a Nurse Practitioner in the JACKSON area and has over 16 years of experience. Dominique Mechelle Jackson primary office location is at 766B LAKELAND DR and new patients are welcome to contact this healthcare provider for an appointment. We do not know where she was educated but we know that she graduated in 2008 The NPI number is 1679000814 and the information was updated approximately 3 years ago.
Dominique Mechelle Jackson is affiliated with one medical group in the JACKSON area, GARVEY WELLNESS CLINIC, INC.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 901975 | MS |
No Identifiers found
| Taxonomy | State | Primary? |
|---|---|---|
| Nurse Practitioner - Taxonomy Code 363L00000X | MS | Y |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | I20210504000885 |
| PECOS Individual PAC ID: | 2466720669 |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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